EXCLUDEDPROVIDER
Individual Revocation

Kazi M Jackson

Vallejo, CA 94589

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Kazi M Jackson of Vallejo, CA is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of April 19, 2012.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Vallejo, CA 94589
Exclusion date
April 19, 2012
Exclusion type
Revocation (1128b4)
Source dataset
May 2026

Record summary

Kazi M Jackson appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Vallejo, California. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is April 19, 2012, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateApril 19, 2012
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Vallejo, CA 94589. The listed provider category is Individual - Licensed Health Care Service Provider. The listed specialty is Nurse / Nurses Aide.

Other excluded providers in Vallejo, CA

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Vallejo, CA address.

Daniela Kaye Gutierrez Individual Drug Felony
Vallejo, CA · Felony conviction relating to controlled substance · Excluded Sep 2020
Derrick Glenn Bracy Individual Revocation
Vallejo, CA · License revocation, suspension, or surrender · Excluded May 2020
Ronald Mesia Moralde Individual Felony Fraud
Vallejo, CA · Felony conviction relating to health care fraud · Excluded Feb 2017
Russel Lanas Discipulo Individual Patient Abuse
Vallejo, CA · Conviction relating to patient abuse or neglect · Excluded Jan 2017
Kenneth Wimer Individual Revocation
Vallejo, CA · License revocation, suspension, or surrender · Excluded Oct 2016
Monica Ann Archuleta Individual Revocation
Vallejo, CA · License revocation, suspension, or surrender · Excluded Sep 2015
Dolores Hallare Regala Individual Revocation
Vallejo, CA · License revocation, suspension, or surrender · Excluded Jan 2015
Sepe Alwin Alik Individual Revocation
Vallejo, CA · License revocation, suspension, or surrender · Excluded Nov 2014

See all 61 excluded providers in Vallejo →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

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Related

More Excluded Individuals in California More Records in Vallejo More Revocation Records